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General NPI Number Information
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NPI Number | 1255900395
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Entity Type | Organization
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Legal Business Name | ALLY ENDOCRINOLOGY PLLC
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 1380 COOLIDGE HWY STE 220
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City | TROY
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State | MI
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Zip | 48084-7068
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Country | US
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Telephone | 248-825-3764
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Fax | 833-391-2161
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Provider Business Mailing Address
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Address Line | 755 W BIG BEAVER RD STE 2020
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City | TROY
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State | MI
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Zip | 48084-4925
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Country | US
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Telephone | 248-825-3764
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Fax | 833-391-2161
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. VIN P
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Credential |
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Telephone | 248-825-3764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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